Play Promotes Parent/Child Interaction

Given that we at SaintA are committed to providing trauma informed care and leading efforts on spreading awareness of the effects of Adverse Childhood Experiences (ACEs), it naturally follows that we are exploring opportunities to prevent ACEs. Children under the age of 5 are most at risk for various forms of child maltreatment, and children under 3 are especially vulnerable. Children with emotional or behavioral challenges are at higher risk still.

Tricia Schutz

Put these two risk categories together and the number of ACEs increases exponentially. One method of early care intervention and ACE prevention that SaintA has adopted is providing caregivers of infants and toddlers opportunities to develop and enhance existing social and emotional skills through a parent-child play group call Parents Interacting with Infants, or PIWI.

The PIWI philosophy is heavily drawn from Wisconsin’s evidence-based Pyramid Model, which focuses on providing optimal relational opportunities and engaging environments for children, to promote well-being and provide a foundation for success in school, community and home environments.

PIWI provides opportunities for caregivers and infants to have shared experiences filled with attunement, shared attention and enjoyment in the context of play. The play group is structured to provide one infant and one caregiver quality time together, doing games, activities and songs that adhere to a weekly developmental topic over the course of an hour and a half.

The group is facilitated by PIWI-trained SaintA clinicians who observe interactions within each duo and respond with gentle guidance to enhance the relational potential between caregiver and child. The facilitator may help the caregiver focus attention to what the child is doing, may be feeling, or to a specific developmental milestone that is observed. The facilitator also may provide suggestions or model certain skills that may be needed. Perhaps the most important role of the facilitator, however, is providing caregivers with feedback that bolsters their competence as caregivers.

The facilitator may say, “Wow! He really loved it when you tickled his belly like that!” or “Look how she lights up when she sees you!” The facilitator also may take on a voice from the infant’s point of view while highlighting a developmentally relevant observation, such as, “Look, Mom! I’m pulling myself up!”

These seemingly simplistic comments resonate deeply with caregivers and can promote a sense of mastery in their parenting that then transmits a sense of mastery to the infant. This parallel process, whereby the facilitator scaffolds the skills of the caregiver, so that the caregiver can scaffold the emerging skills of the infant, produces a cascade of benefits not just for the parent or for the child, but for their relationship.

Children who have attuned, attentive and sensitive caregiving are significantly less likely to experience ACEs, have greater capacity to achieve developmental milestones, and have the social and emotional trajectory needed to be successful in the home, school and community. PIWI targets this objective with a preventative approach that is based in cultivating rich and strong relationships and providing a voice for the infant.

During our fall PIWI session, we had the pleasure of meeting Rozena and her 2-year-old son, Qua’Sean. Rozena described Qua’Sean as being shy and unsure of new situations and new people. She hoped that attending PIWI might help him prepare for the transition to preschool when he turned 3. Coming to PIWI provided Qua’Sean with the opportunity to “practice” meeting new people in a new setting and to engage in developmentally stimulating activities with his mother, allowing him to feel secure by her presence and proximity while trying new things.

Rozena and Qua’Sean

One of the PIWI sessions Rozena and Qua’Sean attended focused on the developmental topic, “What am I like?” It is designed to enhance understanding of the individual temperament of the infant and how it may be similar to or different from the temperament of the caregiver. To get specific profiles and customized recommendations, Rozena completed the Infant Toddler Temperament Tool (IT3) during PIWI and was provided with strategies to bridge the differences between her and Qua’Sean. Rozena was excited to have something she could take home and use in their everyday life.

One item in particular that Rozena appreciated was the recommendations about the temperament trait of “sensitivity,” referring to “how sensitive one is to physical stimuli such as light, sound and textures.” Rozena explained that she found it challenging to get Qua’Sean to enjoy bath time and felt that it was a regular struggle that caused them both to feel frustrated. After reviewing the IT3 recommendations and talking with Rozena about strategies to try, we incorporated water play into the PIWI session. Using a water table (a play surface that can hold water, like a miniature pool with legs) filled with warm soapy water, Rozena and Qua’Sean simply began to fill up and pour out cups of water together and even began to pretend to cook together. Rozena was surprised by how much Qua’Sean enjoyed playing with the water.

When they returned the next week to their PIWI session, Rozena was excited to share that she had used the strategies she had learned during bath time at home, and it was a great success. She said that Qua’Sean enjoyed the bath and seemed to relax and play without the usual frustration that they’d experienced before. She shared her experience with the group, and the pride she felt about overcoming this challenge was obvious. Qua’Sean was proud to share that he had taken a bath like a “big boy,” too.

They were able to find a way to change a challenging situation into a shared joyful experience that supported both Rozena’s sense of competence as a parent and Qua’Sean’s sense of accomplishment at mastering a task. Rozena and Que’Sean enjoyed PIWI so much that they attended the winter round of group as well despite having to travel a farther distance. And at the conclusion of the winter group, Qua’Sean happily enrolled in pre-school.